What you need to do.

Since bad breath is caused by the smelly waste products (volatile sulfur compounds, VSC's) created by anaerobic oral bacteria, curing it must involve steps targeted directly at curbing the number of them that live in your mouth.

You accomplish this by:

Removing the types of environments in your mouth in which these bacteria like to live.

Making any location in which they do live less hospitable for them.

Limiting the amount of nutrients they have available.

Then as an additional measure, a person may choose to use additional products that can help to kill bacteria or neutralize volatile sulfur compounds (VSC's). (What are the best mouthwashes for bad breath.)

A game plan for curing bad breath -

Research has shown that most cases of bad breath (as many as 90%) can be directly attributed to factors originating in the person's mouth. These factors include poor dental hygiene, tongue film/coating and gum disease (Bartold 2016) [page references].

Once this point is understood, treating as well as preventing breath odors becomes a pretty straightforward affair.

The steps you need to take -

A) Effective mouth cleaning.

Flossing removes smelly bacteria that live below the gum line.

1) Tooth brushing and flossing.

The types of bacteria that cause bad breath live in the dental plaque that builds up on and around teeth both above and especially below the gum line (see illustration).

Removing this plaque removes a home for these bacteria. And the fewer of them that there are in your mouth, the fresher your breath will be.

Both brushing AND flossing is needed. It's not realistic to think that smells coming from around teeth can be controlled unless effective flossing is an integral part of the person's daily oral home care.

Nothing is more important than cleaning the back part of the dorsum (top surface) of your tongue.

2) Cleaning your tongue- Nothing is more important!

In most cases, when it comes to curing your breath problems nothing is more important than cleaning your tongue. (Pham 2011).

More specifically, it's necessary to remove the film (white coating) that's accumulated on the dorsum of your tongue (meaning its top surface), all of the way in back (see picture).

This is likely the most important step you can take.

Simply incorporating this single step into your mouth-cleaning routine (a twice-daily schedule may be needed) is likely to do more than any other type of cure you can institute.

If you need evidence of this fact, read the contents of the "Research on this matter" box below.

This point is so important we felt it necessary to dedicate an entire page to it.

Research on this matter.

1) A study (Washio 2005) analyzed the types of bacteria living in the biofilm accumulation on the surface of test subject's tongues. (None of the subjects had severe gum disease, which would have been a complicating issue for this study.)

The primary species of odor causing (VSC producing) bacteria found were were Veillonella, Actinomyces, and Prevotella. This was true for both subjects that did and did not have significant breath problems.

The test subjects that had oral malodor had significantly higher numbers of these bacteria (a higher density), although the total quantity of coating in both groups was similar.

This suggests that bad breath can be controlled by limiting the number of VSC-producing bacteria found on a person's tongue. In the case of tongue cleaning, it simply removes the film that harbors the problematic organisms.

2) Another study (Pham 2011) evaluated the effectiveness of tongue cleaning in curing halitosis in test subjects that had significant vs. minor involvement with gum disease.

It determined that tongue cleaning alone made statistically significant reductions in malodor levels in both groups, characterizing the improvement for the minor group as "marked."

It concluded that in the latter case, tongue cleaning alone can serve as the primary approach to reducing oral odors.

3) Oral rinses.

You may choose to include the use of a mouthwash or rinse in your home-care routine. As benefits, the best ones have antibacterial and VSC-neutralizing properties.

Don't rely on these kinds of products alone.

Our opinion would be that these products should only be considered to be a supplementary rather than primary method of controlling oral bacteria and their byproducts. Here's why:

Rinses typically have a tough time penetrating the full thickness of oral films. And that means that it's difficult for them to be effective.

(The bacteria living on or near a film's surface receive the treatment. Those living in its deepest recess may receive no effect at all.)

In comparison, the mechanical disruption/removal of oral films by brushing, flossing and tongue scraping is quite predictable and unquestionably effective.

B) Limiting the food supply for bacteria.

The volatile sulfur compounds that cause bad breath are the waste byproducts created by anaerobic oral bacteria as they digest proteins. That's why it's so important for a person to clean their mouth thoroughly after eating, and especially after consuming foods that have high protein content.

When we're finished eating, minute particles of food still remain in our mouth. A lot of this debris ends up in between our teeth and incorporated into the coating found on the back part of our tongue.

Since these are precisely the locations in which the bacteria that cause bad breath live, if a person doesn't clean their mouth promptly and thoroughly, food is provided for them over an extended period of time.

Dental cleanings remove tartar and associated debris that you can't.

C) Making sure your mouth is healthy.

If your breath problems persist even after a period of following all of the tips and suggestions we make on our pages, you should schedule an examination and cleaning appointment with your dentist so they can evaluate your situation.

During your appointment, the following topics can be addressed ...

1) Effective brushing and flossing technique can be difficult to learn. Your dentist should be able to provide you with instructions, tips, and pointers that can help to improve your routine.

2) Dental calculus (tartar) accumulation can interfere with effective brushing and flossing as well as harbor bacteria. Your dental cleaning will remove this debris from your teeth, both above and below the gum line (see animation).

Healthy vs. diseased gums.

Gum disease creates pockets that harbor smelly bacteria.

3) A part of your dentist's examination will include a periodontal evaluation.

Periodontal disease (gum disease) can cause significant damage to your gums and the bone that surrounds them (gum recession and bone loss, see animation).

This damage can result in the creation of deep spaces between your teeth called "periodontal pockets." These pockets are often impossible for you to clean effectively (especially once tartar has formed in them) and therefore make an ideal environment for the bacteria that cause bad breath to live.

If a periodontal problem is found, your dentist can outline the treatment that will be needed to get your condition under control.

4) During your examination your dentist will check to see if there are any untreated dental conditions that could be causing or aggravating your breath problems.

5) Your dentist can determine if it's unlikely that oral conditions are the cause of your bad breath and that a referral to a doctor for a medical evaluation is indicated.

Takeaways from this section.

Even in the case where your dentist has been able to identify and correct dental disease that seemingly plays a major role in your malodor problems, total resolution may not be achieved.

Research suggests that up to 25% of the general population suffers from halitosis despite having good oral health (Lenton 2012). In these cases, it's likely that tongue cleaning (see above) is the needed additional step.

D) Keeping your mouth hydrated can help.

Oral moisture helps to wash away oral bacteria, and wash out and dilute the smelly compounds they've created. (Having a chronically dry mouth is a risk factor for bad breath.)

On a daily basis, here are some of the things you can do to keep your mouth moist.

1) Drink plenty of water.

If you allow yourself to become dehydrated, your body will attempt to conserve moisture by way of reducing its production of saliva. Saliva has a cleansing and diluting effect on the bacteria and bacterial waste products that cause bad breath.

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2) Expose your mouth to water throughout the day.

Rinsing frequently with water can help to control odors over the short-term by way of removing and diluting bacterial waste products. Doing so will also tend to dislodge and rinse away the bacteria themselves, as well as food debris that might otherwise have become a food source for them.

Just the act of drinking water can help to control breath odors for up to an hour. (Bartold 2016)

3) Stimulate your mouth's flow of saliva.

One way to stimulate salivary flow is to chew on something. Doing so will trick your body in to thinking that it is getting a meal. In preparation for digesting this meal, your body will increase its production of saliva. You might choose to chew on cloves, fennel seeds, or a piece of mint or parsley.

Chewing gum, or breath mints or lozenges, can also be used to stimulate salivary flow. If you elect to use one of these products, make sure it is sugar-free since sweets will promote the growth of bacteria that cause tooth decay.